Comprehensive Strategy to Decolonize Methicillin-Resistant Staphylococcus aureus in the Outpatient Setting: a Randomized Controlled Study

Abstract

The objective of this study was to examine the efficacy of a comprehensive decolonization treatment in reducing methicillin-resistant Staphylococcus aureus (MRSA) carriage among an outpatient population. Patients colonized with MRSA were randomized to receive pharmacological decolonization treatment or no treatment. The primary outcome was detection of MRSA at 3 months. Occurrence of MRSA infection was assessed at 6 months. Molecular analyses were performed on all MRSA isolates. Of 205 patients, 15 (7%) were enrolled into the study (9 treatment; 6 control). At 3 months, 4/8 (50%) in the treatment group had eradication and none in the control group (0/4, 0%). Infection occurred in 5 patients (3 treatment; 2 control). All of the MRSA isolates were community-associated MRSA strain types with USA300 accounting for 87%. Among persistent CA-MRSA carriers, our decolonization treatment was well tolerated. However, enrollment was limited. Future studies with different enrollment strategies are required.